Individual provider Active NPI

Samantha Joelle Lupton, AA-C

  • Anesthesiologist Assistant
  • Raleigh, NC
National Provider Identifier
1821224858
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
200000010 Issued in NC
Practice address
2308 Wesvill CT
Raleigh, NC 27607-2949
Phone
(919) 781-4311
NPI assigned
Jun 4, 2009
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 2009030827 MO
Anesthesiologist Assistant 367H00000X 200000010 NC Primary

Addresses

Primary practice location

2308 Wesvill CT
Raleigh, NC 27607-2949

Mailing address

3635 Vista Ave
Saint Louis, MO 63110-2539
Phone (985) 264-6438

Other practice location 1

3635 Vista Avenue
St Louis, MO 63110
Phone (314) 268-7267

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Slupton24389@direct-ehr-ssmhc.com Direct
FHIR URL HTTPS://fhir.ssmhc.com/fhir/api/FHIR/DSTU2 Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221109001335 NC Practitioner - Anesthesiology Assistant 3375682503 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
200000010NCMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC CurrentSince Sep 26, 2022 Accepting new patients
American Anesthesiology of North Carolina, PLLC CurrentSince Sep 26, 2022 Accepting new patients
Sluh Anesthesia Physicians, L.L.C. Past Accepting new patients

Locations

2308 Wesvill Ct
Raleigh, NC 27607
Phone (919) 781-4311

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Interoperability endpoints

  • Direct secure messaging: slupton24389@direct-ehr-ssmhc.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1821224858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "985-264-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 WESVILL CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276072949",
            "telephone_number": "919-781-4311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3635 Vista Avenue",
            "address_purpose": "LOCATION",
            "city": "St Louis",
            "state": "MO",
            "postal_code": "63110",
            "country_code": "US",
            "telephone_number": "314-268-7267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUPTON",
        "first_name": "SAMANTHA",
        "middle_name": "JOELLE",
        "credential": "AA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2009030827",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "NC",
            "license": "200000010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Slupton24389@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Slupton24389@direct-ehr-ssmhc.com",
            "address_1": "3635 Vista Avenue",
            "city": "St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "HTTPS://fhir.ssmhc.com/fhir/api/FHIR/DSTU2",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3635 Vista Avenue",
            "city": "St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.